Severity of non‐alcoholic steatohepatitis is associated with substitution of adipose tissue in skeletal muscle

Kitajima, Yoichiro; Hyogo, Hideyuki; Sumida, Yoshio; Eguchi, Yuichiro; Ono, Naofumi; Kuwashiro, Takuya; Tanaka, Kenichi; Takahashi, Kazuhiro; Mizuta, Toshihiko; Ozaki, Iwata; Eguchi, Takahisa; Kimura, Yuki; Fujimoto, Kazuma; Anzai, Keizo

doi:10.1111/jgh.12227

Cited by 111 publications

(106 citation statements)

References 54 publications

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“…Therefore, numerous clinical researches have started to employ muscle quality to define sarcopenia. As CT-assessed muscle quality indexes, MA and IMAC have been confirmed to be valid predictors of major complications and survival in many studies [62,63], and these conclusions were consistent with the outcomes of this metaanalysis. Owning to the scarcity of original publication, the overall effect of HUAC and LPMA could not be pooled; however, the predictive value of these 2 indexes has also been confirmed in other studies [64,65].…”

Section: Discussionsupporting

confidence: 78%

Computed Tomography-Assessed Sarcopenia Indexes Predict Major Complications following Surgery for Hepatopancreatobiliary Malignancy: A Meta-Analysis

et al. 2018

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Background: Computed tomography (CT)-assessed sarcopenia indexes have been reported to predict postoperative morbidity and mortality; however conclusions drawn from different indexes and studies remain controversial. Aim: The purpose of this meta-analysis was to evaluate various CT-assessed sarcopenia indexes as predictors of risk for major complications in patients undergoing hepatopancreatobiliary surgery for malignancy. Methods: Medline/PubMed, Web of Science, and Embase databases were systematically searched to identify relevant studies published before June 2018. PRISMA guidelines for systematic reviews were followed. The pooled risk ratio (RR) for major postoperative complications (Clavien-Dindo ≥III) was estimated in patients with sarcopenia versus patients without sarcopenia. Data extracted were meta-analyzed using Review Manager (version 5.3). Results: Twenty-eight studies comprising 6,656 patients were included in this study. CT-assessed sarcopenia indexes, such as skeletal muscle index (SMI, RR 1.36; 95% CI 1.14–1.63; p = 0.0008; I² = 24%), psoas muscle index (PMI, RR 1.35; 95% CI 1.15–1.58; p = 0.0002; I² = 0%), muscle attenuation (MA, RR 1.40; 95% CI 1.14–1.73; p = 0.002; I² = 4%), and intramuscular adipose tissue content (IMAC, RR 1.63; 95% CI 1.28–2.09; p < 0.0001; I² = 0%) were all predictors of postoperative major complications, although moderate heterogeneity existed and cutoffs for these indexes to define sarcopenia varied. Conclusions: All commonly used CT-assessed sarcopenia indexes, such as SMI, PMI, MA, and IMAC can predict the risk of major postoperative complications; however, a consensus on the cutoffs for these indexes to define sarcopenia is still lacking.

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Section: Discussionsupporting

confidence: 78%

Computed Tomography-Assessed Sarcopenia Indexes Predict Major Complications following Surgery for Hepatopancreatobiliary Malignancy: A Meta-Analysis

et al. 2018

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“…The dorsal muscle group area is also a useful prognostic factor (12). Furthermore, dorsal muscle group quality (i.e., fat accumulation of the muscle) has been demonstrated to be an indicator of non-alcoholic fatty liver disease and nonalcoholic steatohepatitis (13,14).…”

Section: Original Articlementioning

confidence: 99%

“…The dorsal muscle group adiposity at the lower border of Th12 was furthermore defined as the intramuscular adipose tissue content (IMAC) following Kitajima et al (13,14). The density of the dorsal muscle group was measured at the lower border of Th12 using plain CT images.…”

Section: Image Analysismentioning

confidence: 99%

“…CT values of subcutaneous adipose tissues (SAT) were also measured at four points, keeping away from major vessels using circle ROIs with a diameter of 6 mm. IMAC was calculated as previously described by Kitajima et al; it was calculated as the mean CT value of the dorsal muscle group (Hounsfield units) divided by the mean CT value of SAT (Hounsfield units), which indicates the degree of steatosis (14). IMAC is normally a negative value.…”

Section: Image Analysismentioning

confidence: 99%

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Longitudinal CT study of sarcopenia due to hepatic failure after living donor liver transplantation

Onuma

Kamishima

Shimamura

et al. 2018

Quant. Imaging Med. Surg.

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Background:The quantity and quality of skeletal muscle have been observed to be closely related with post-transplantation mortality in patients undergoing living donor liver transplantation (LDLT). However, the effect of LDLT on skeletal muscle has not been thoroughly investigated. The aim of this study was to investigate the change of trunk muscle mass and adiposity in recipients of LDLT. Results: A statistically significant correlation was detected between pre-operative values and follow-up differences in DMGMI for both sexes (male: r=−0.675, P=0.008; female: r=−0.687, P=0.002) and in PMI for both sexes (males: r=−0.739, P=0.003; females: r=−0.641, P=0.006). The correlation of pre-operative values and follow-up differences for IMAC was not statistically significant with r=0.132 (P=0.700) and r=−0.498 (P=0.071) for males and females, respectively.Conclusions: Improvement of sarcopenia in recipients of LDLT can be demonstrated regardless of sex using volumetric CT.

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“…1a), and PMI was calculated by normalizing this cross-sectional area of bilateral psoas muscles to the square of the patient's height in meters. IMAC was calculated as previously described by Kitajima et al [20]: IMAC = mean CT attenuation value (in Hounsfield units) for region of interest in multifidus muscle / mean CT attenuation value for region of interest in subcutaneous fat.…”

Section: Image Analysismentioning

confidence: 99%

Preoperative Low Muscle Mass and Low Muscle Quality Negatively Impact on Pulmonary Function in Patients Undergoing Hepatectomy for Hepatocellular Carcinoma

et al. 2017

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Background: Sarcopenia is a prognostic factor for mortality in digestive surgery. However, the correlation between preoperative cardiopulmonary function and sarcopenia in patients undergoing hepatectomy for hepatocellular carcinoma (HCC) remains unclear. Methods: The present study investigated the impact of preoperative sarcopenia on cardiopulmonary function in 402 patients who underwent first hepatectomy for HCC between April 2005 and April 2015. The quantity and quality of skeletal muscle were evaluated using psoas muscle index (PMI) and intramuscular adipose tissue content (IMAC), respectively, as determined from preoperative computed tomography imaging. Correlations between preoperative cardiopulmonary function and sarcopenic factors (PMI and IMAC) were evaluated. Results: No significant correlations were found between left ventricular ejection fraction and the two sarcopenic factors. On the other hand, preoperative vital capacity (VC) and forced expiratory volume in 1 s (FEV₁) correlated significantly with PMI (p < 0.001 each) in males and with IMAC (p < 0.001 each) in females. Moreover, VC and FEV₁ in the preoperative low PMI (p < 0.001 each) and high IMAC (p = 0.002 and p < 0.001, respectively) groups were significantly lower than in the normal group in males. In females, VC and FEV₁ were significantly lower in the preoperative high IMAC group than in the normal group (p < 0.001 each). Conclusion: Preoperative low muscle mass in males and low muscle quality in males and females were significantly associated with pulmonary dysfunction.

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Severity of non‐alcoholic steatohepatitis is associated with substitution of adipose tissue in skeletal muscle

Abstract: These results suggest that skeletal muscle fat accumulation may have been linked to the pathogenesis and severity of NASH.

Cited by 111 publications

References 54 publications

Computed Tomography-Assessed Sarcopenia Indexes Predict Major Complications following Surgery for Hepatopancreatobiliary Malignancy: A Meta-Analysis

Computed Tomography-Assessed Sarcopenia Indexes Predict Major Complications following Surgery for Hepatopancreatobiliary Malignancy: A Meta-Analysis

Longitudinal CT study of sarcopenia due to hepatic failure after living donor liver transplantation

Preoperative Low Muscle Mass and Low Muscle Quality Negatively Impact on Pulmonary Function in Patients Undergoing Hepatectomy for Hepatocellular Carcinoma

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